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CC Payments
Contact Information
Name
*
First Name
Last Name
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Email
*
Phone
*
Adoption - Cat
Quantity
$195
-
Kitten
0
1
2
2
$155
-
Kitten - Veteran/Senior Discount
0
1
2
2
$145
-
Adult
0
1
2
2
$95
-
Adult - Veteran/Senior Discount
0
1
2
2
$195
-
Adult Bonded Pair
0
1
2
2
$75
-
Senior
0
1
2
2
$45
-
Senior - Veteran/Senior Discount
0
1
2
2
$95
-
Senior Bonded Pair
0
1
2
2
$25
-
Barn Cat
0
1
2
3
4
4
Adoption - Dog
Quantity
$395
-
Puppy
0
1
2
2
$375
-
Puppy - Veteran/Senior Discount
0
1
2
2
$295
-
Adult
0
1
2
2
$245
-
Adult - Veteran/Senior Discount
0
1
2
2
$495
-
Adult Bonded Pair
0
1
2
2
$195
-
Senior
0
1
2
2
$145
-
Senior - Veteran/Senior Discount
0
1
2
2
$295
-
Senior Bonded Pair
0
1
2
2
Adoption - Small Animals
Quantity
$50
-
Rabbit
0
1
2
2
$25
-
Rabbit - Veteran/Senior Discount
0
1
2
2
$75
-
Rabbit Bonded Pair
0
1
2
2
$50
-
Ferret
0
1
2
3
4
4
$25
-
Ferret - Veteran/Senior Discount
0
1
2
3
4
4
$75
-
Ferret Bonded Pair
0
1
2
3
4
4
$50
-
Chinchilla
0
1
2
2
$25
-
Chinchilla - Veteran/Senior Discount
0
1
2
2
$75
-
Chinchilla Bonded Pair
0
1
2
2
$25
-
Guinea Pig
0
1
2
3
4
4
$15
-
Guinea Pig - Veteran/Senior Discount
0
1
2
3
4
4
$35
-
Guinea Pig Bonded Pair
0
1
2
3
4
4
$10
-
Rodent
0
1
2
3
4
4
$5
-
Rodent - Veteran/Senior Discount
0
1
2
3
4
4
$15
-
Rodent Bonded Pair
0
1
2
3
4
4
Adoption - Other
$
Other Adoption Description (Species)
Surrender
$
Return to Owner
$
Donation at Front Desk
$
Microchip
Quantity
$15
0
1
2
3
4
5
6
6
Rabies Vaccine
Quantity
$15
0
1
2
3
4
5
6
6
Customer Retail Purchase (collar, leash, etc.)
$
S/N Clinic
Quantity
$250
-
Dog S/N
0
1
2
3
4
5
6
7
8
9
10
10
$20
-
Add-on Fee (i.e. over 80 lbs)
0
1
2
3
4
5
6
7
8
9
10
10
$85
-
Cat S/N
0
1
2
3
4
5
6
7
8
9
10
10
$95
-
Rabbit S/N
0
1
2
3
4
5
6
7
8
9
10
10
S/N Clinic - Financial Assistance Fee
$
Staff Purchase (pet food, supplies, etc.)
$
Other
$
Notes